Long-term exposure to ambient fine particulate matter (PM 2.5 ) and attributable pulmonary tuberculosis notifications in Ningxia Hui Autonomous Region, China: a health impact assessment

作者：Igor Popović, Ricardo J. Soares Magalhães, Shukun Yang, Yurong Yang, Bo‐Yi Yang, Guang‐Hui Dong, Xiaolin Wei, Joe Van Buskirk, Gregory J. Fox, Erjia Ge, Guy B. Marks, Luke D. Knibbs · 发表于：BMJ Open · 年份：2024 · DOI：10.1136/bmjopen-2023-082312 · 被引用次数：3 · 研究领域：Air Quality and Health Impacts、Climate Change and Health Impacts、Energy and Environment Impacts

Introduction Long-term exposure to fine particulate matter (≤2.5 µm (PM 2.5 )) has been associated with pulmonary tuberculosis (TB) notifications or incidence in recent publications. Studies quantifying the relative contribution of long-term PM 2.5 on TB notifications have not been documented. We sought to perform a health impact assessment to estimate the PM 2.5 - attributable TB notifications during 2007–2017 in Ningxia Hui Autonomous Region (NHAR), China. Methods PM 2.5 attributable TB notifications were estimated at township level (n=358), stratified by age group and summed across NHAR. PM 2.5 -associated TB-notifications were estimated for total and anthropogenic PM 2.5 mass and expressed as population attributable fractions (PAFs). The main analysis used effect and uncertainty estimates from our previous study in NHAR, defining a counterfactual of the lowest annual PM 2.5 (30 µg/m 3 ) level, above which we assumed excess TB notifications. Sensitivity analyses included counterfactuals based on the 5th (31 µg/m 3 ) and 25th percentiles (38 µg/m 3 ), and substituting effect estimates from a recent meta-analysis. We estimated the influence of PM 2.5 concentrations, population growth and baseline TB-notification rates on PM 2.5 attributable TB notifications. Results Over 2007–2017, annual PM 2.5 had an estimated average PAF of 31.2% (95% CI 22.4% to 38.7%) of TB notifications while the anthropogenic PAF was 12.2% (95% CI 9.2% to 14.5%). With 31 and 38 µg/m 3 as counterfactua...